依托咪酯复合舒芬太尼在老年颅脑手术麻醉诱导效果观察

发布时间：2017-12-27 13:31

本文关键词：依托咪酯复合舒芬太尼在老年颅脑手术麻醉诱导效果观察　出处：《中国实用神经疾病杂志》2016年22期 　论文类型：期刊论文

【摘要】：目的探讨依托咪酯复合舒芬太尼在老年颅脑手术麻醉诱导中的应用效果。方法选取我院神经外科择期颅脑手术的老年患者80例为研究对象,ASAⅡ~Ⅲ级,采用随机数字表法将患者分为芬太尼组(40例)和舒芬太尼组(40例),麻醉诱导时给予咪唑安定、依托咪酯、芬太尼或舒芬太尼、维库溴铵静注,记录2组患者诱导前(T1)、诱导后(T2)、插管即刻(T3)、插管后1min(T4)和插管后10min(T5)血流动力学变化,记录2组意识消失时间、自主呼吸恢复时间和拔管时间,对比记录2组不良反应。结果与TI对比,2组T3、T4段HR均明显升高,对照组T3、T4、T5段MAP显著升高,差异显著(P0.05);观察组不同时间段MAP无显著差异(P0.05);观察组T3、T4、T5时间段HR、MAP显著低于对照组,差异具有统计学意义(P0.05);观察组意识消失时间、自主呼吸恢复时间、拔管时间分别为(3.71±0.43)min、(11.52±2.97)min、(31.26±3.04)min,均短于对照组,差异具有统计学意义(P0.05);观察组肌阵挛发生率(5.0%)显著低于对照组(20.0%),差异具有统计学意义(P0.05)。结论老年颅脑手术采用依托咪酯复合舒芬太尼行诱导麻醉,能够维持插管前后血流动力学稳定,提高手术安全性。
[Abstract]:Objective to investigate the effect of etomidate combined with sufentanil in the induction of anesthesia induction in elderly patients with craniocerebral operation. Methods the Department of Neurosurgery undergoing neurosurgery in our hospital 80 cases of elderly patients as the research object, ASA II or III patients were randomly divided into fentanyl group (40 cases) and sufentanil group (40 cases), given midazolam and etomidate during induction of anesthesia, fentanyl or sufentanil and vecuronium infusion. Records of 2 groups of patients before induction (T1), after induction (T2), immediately after intubation (T3), 1min after intubation (T4) and 10min after intubation (T5) hemodynamic changes, 2 groups consciousness loss time, breathing recovery time and extubation time, record for comparison of the adverse reactions of the 2 groups. Results compared with TI, T3, T4 2 groups of HR were significantly higher in control group, T3, T4 and T5 MAP were significantly increased, significant difference (P0.05); the observation group MAP at different time had no significant difference (P0.05); the observation group T3, T4, T5, MAP time HR was significantly lower than control group. The difference was statistically significant (P0.05); observation group consciousness loss time, breathing recovery time, extubation time was (3.71 + 0.43), min (11.52 + 2.97), min (31.26 + 3.04) min, were shorter than the control group, the difference was statistically significant (P0.05); observation group myoclonus the incidence (5%) was significantly lower than the control group (20%), the difference was statistically significant (P0.05). Conclusion etomidate combined with sufentanil can maintain the stability of hemodynamics before and after intubation and improve the safety of operation.
【作者单位】：西安市中心医院;
【分类号】：R614
【正文快照】： 老年患者全身器官功能衰退,心脏收缩功能下降,且颅脑手术会降低颅内顺应性,麻醉诱导期间,可能造成剧烈血流动力学改变,降低手术安全性[1]。因此,临床应尽量选择镇静效果好、对心血管作用小的麻醉药物行全麻诱导麻醉。依托咪酯是临床常用的诱导麻醉药物,对呼吸功能影响小,但镇

【相似文献】